Folliculitis (cont.)

Gary W. Cole, MD, FAAD

Dr. Cole is board certified in dermatology. He obtained his BA degree in bacteriology, his MA degree in microbiology, and his MD at the University of California, Los Angeles. He trained in dermatology at the University of Oregon, where he completed his residency.

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

What are common types of folliculitis?

Steroid folliculitis

Cutting oil folliculitis

Machinists exposed to insoluble cutting oils that are used to decrease the friction between machine tools and metal parts can develop a folliculitis on the exposed skin.

Staphylococcal folliculitis

Staphylococci are bacteria that commonly inhabit the skin. One species, S. aureus, is a frequent cause of folliculitis. Occasionally, this organism may be insensitive to a number of commonly used antibiotics (such as methicillin-resistant Staphylococcus aureus, or MRSA). In this situation, it is very important that a culture of the organism with sensitivities be performed so the ideal antibiotic is selected.

What is hot tub folliculitis or Jacuzzi folliculitis?

Hot tub folliculitis is caused by the bacteria Pseudomonas aeruginosa. This condition is likely to occur from bathing in poorly maintained hot tubs. It is most common on the back and causes scattered pinpoint, small red to purple bumps all over the torso. These may be very itchy or have no symptoms at all. Typically, there is a history of sitting in a hot tub days prior to the start of the bumps. It is good practice to rinse off the skin in a shower after this sort of bathing.

The hot tub should be tested and possibly treated by trained pool and spa personnel for bacterial overgrowth. Affected patients may be more prone to recurrences in the future and should be cautious about hot tub use. Although this condition often resolves without treatment, it may be useful to rinse the skin with dilute vinegar.

What is razor burn folliculitis?

Razor-burn folliculitis is very common on the male neck and women's legs and is caused by shaving. Repeated passes by the razor produces tiny cuts that allow bacteria to enter the skin and invade the deeper hair follicles. Additionally, excessively close shaving may cause trapping of small hairs beneath the skin surface, causing more inflammation.

Treatment involves stopping shaving with a razor for a few days to a few weeks and using antibacterial washes and topical antibiotics. Additional treatments include laser hair removal, electrolysis, electric razors, or cream depilatories like Neet or Nair. Frequently, shaving less vigorously and leaving a small bit of stubble is advisable.